Specimen collection pgs , , and The lab or pathology department does countless types of examinations on every type of body fluid & tissue that exists

Hematological studies Venous or arterial blood are drawn for examination in the lab CBC, HGB and HCT (H & H), WBC, etc.

Urinalysis Urine collection methods vary according to the type of test to be performed Most common to the surgical tech would be to obtain a sterile specimen from a urinary catheter and cysto cases

Tissue specimens Body fluids & tissue samples are removed from the body to determine the exact nature of a disease or for treatment of a condition Several methods exist for removing fluid & tissue from the body

Needle aspiration: A fine needle and syringe are used to withdraw a sample Incisional biopsy: The lesion is incised and a portion is removed for study Excisional biopsy: The entire tumor is removed and examined

During biopsy, small amounts of suspect tissue or fluid may be aspirated by needle or excised through a surgical incision and sent to the lab to determine the type of infection or neoplasm, or the degree of tumor metastasis (staging)

Intra-operatively, if an immediate diagnosis is necessary for a decision to remove more tissue, the biopsy sample is sent directly to the pathologist for a “frozen section,” which involves freezing the tissue sample, slicing it into thin sections, staining, and microscopic viewing

The pathologist is then able to give an opinion about the nature of the sample If a frozen section is not indicated, the tissue is placed into a container of sufficient size with a fixative solution, such as formalin, before being sent to the lab

Some very large specimens, such as an amputated limb, may require improvised techniques of transport to the lab Be discreet, do not draw attention to the fact you may be pushing a cart with body parts on it. This may be quite upsetting to family members or others

Identify & origin of specimen The surgical tech should be aware of the identity & origin or location of the specimen when receiving it from the surgeon (verify with surgeon) Ask surgeon if you may pass off specimen prior to passing it off Communicate the information about specimen type and origin to the circulator when passing it off the sterile field as well as how it is to be sent to the pathology department (fresh/frozen/permanent (formalin)

Orientation of the specimen becomes important when the margins of the wound must be proven to be free of tumor The tumor edges are marked with suture or other method The STSR should accurately communicate the significance of the markers to the circulator or pathologist

If the specimen must be removed from the sterile field intra-operatively, this must be done in a sterile manner The specimen should be placed in or on a sterile specimen container, telfa pad, towel, or basin A counted surgical sponge should never be used for transport of a specimen.

If the specimen is to remain on the sterile field or back table for any reason, precautions should be taken to prevent it from drying out

Bacteriologic tests Tissue or fluid that is suspected of being infected may be cultured so that the pathogen can be identified and treated. This is called “ culture & sensitivity” or C & S The culture is performed to determine the exact organism; once this is done a determination is made as to which form of antimicrobial treatment it will be sensitive to

Sterile cotton tipped swabs are exposed to the tissue or fluid to be cultured, and then placed in a transport container Aerobic & anaerobic studies may be ordered, each requiring it’s own transport container Anaerobic bacteria die quickly if exposed to air; therefore the swab should be placed quickly into the growth medium

Gram stain The gram stain remains a valuable tool in identifying bacteria. The bacterium is exposed to stains of crystal violet, iodine, & alcohol. Bacteria that are blue are called gram positive & those that fade to pink or red are called gram negative

Spinal tap Cerebrospinal fluid (CSF) is withdrawn (tapped) from the lumbar area of the spinal column for analysis

Thoracentesis This involves the placement of a needle into a posterior portion of the pleural space for the analysis of pleural effusion Applications include the removal of fluid accumulation from within the thoracic cavity. This may be aided with the use of CT or ultrasound for needle placement.